Psychosis. Antipsychotic drugs can treat verbally or physically aggressive behavior and hallucinations. Because older antipsychotic drugs such as haloperidol (Haldol) have severe side effects, most doctors now prescribe newer atypical antipsychotics such as risperidone (Risperdal) or olanzapine (Zyprexa). Although these new antipsychotic drugs appear to have fewer side effects than older drugs, a 2005 study suggested that they may pose a slightly increased risk for death in patients with Alzheimer’s disease or dementia. A 2006 study published in the New England Journal of Medicine found that there are no differences in treatment between placebo and Zyprexa, Risperdal, and the investigational drug Seroqul when used to calm agitation and aggression in people with Alzheimer's. More research is needed.
Some experts recommend that doctors delay prescribing antipsychotic medication unless absolutely necessary. They recommend first trying behavioral treatments and antidepressant drugs. Anti-seizure drugs such as carbamazepine (Tegretol) or valproate (Depakote) can also sometimes treat agitation and other psychotic symptoms.
Disturbed Sleep. Patients with Alzheimer's disease commonly experience disturbances in their sleep/wake cycles. Moderately short-acting sleeping drugs such as temazepam (Restoril), zolpidem (Ambien), or zaleplon (Sonata) or sedating antidepressants such as trazodone (Desyrel, Molipaxin) may be useful in managing insomnia. Some research suggests that exposure to brighter-than-normal artificial light during the day for patients with normal vision may help reset wake/sleep cycles and prevent nighttime wandering and sleeplessness. Trials on melatonin, a natural hormone that helps trigger sleep at night, are in progress.
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